Liu Feifei, Jiang Qi, Sun Xuedong, Huang Yuzhen, Zhang Zhenzhen, Han Ting, Shi Yuhua
Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.
Front Physiol. 2020 Nov 19;11:491892. doi: 10.3389/fphys.2020.491892. eCollection 2020.
To evaluate the effect of dyslipidemia on the incidence of moderate and severe Ovarian hyperstimulation syndrome (OHSS) in the duration of assisted reproduction technique (ART).
The study included 233 moderate and severe OHSS patients who received hospitalization after in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles to avoid severe complications. They were divided into dyslipidemia group and normal lipid metabolism group to evaluate whether dyslipidemia contributes to the development of severe OHSS. Subgroup analysis was set to avoid deviation including the freeze-all group and fresh embryo transfer (ET) group according to whether the eligible women chose fresh embryo transfer immediately after their IVF or ICSI cycles. The main outcome measures included the incidence of moderate OHSS and severe OHSS, total gonadotropin dose, number of oocytes retrieved, age and body mass index (BMI). In the ET groups, the rate of pregnancy is also included for analysis.
In the freeze-all group, lipid metabolism was ultimately identified as the factor affecting the morbidity of severe OHSS and the ones with dyslipidemia were more likely to develop to severe OHSS ( < 0.05), while the incidence of severe OHSS among the ET groups had no statistical significance ( > 0.05).
The findings of this study suggested that dyslipidemia might contribute to the development of OHSS, especially for those patients who chose the cryopreservation of all embryos. It is essential to consider the risk of OHSS in patients with dyslipidemia although they required cryopreservation of all embryos.
评估在辅助生殖技术（ART）过程中，血脂异常对中重度卵巢过度刺激综合征（OHSS）发生率的影响。
本研究纳入了233例中重度OHSS患者，这些患者在接受体外受精（IVF）或卵胞浆内单精子注射（ICSI）周期后住院，以避免严重并发症。将他们分为血脂异常组和正常脂质代谢组，以评估血脂异常是否会导致严重OHSS的发生。根据符合条件的女性在IVF或ICSI周期后是否立即选择新鲜胚胎移植，进行亚组分析以避免偏差，包括全胚冷冻组和新鲜胚胎移植（ET）组。主要观察指标包括中度OHSS和重度OHSS的发生率、总促性腺激素剂量、取卵数、年龄和体重指数（BMI）。在ET组中，还纳入妊娠率进行分析。
在全胚冷冻组中，最终确定脂质代谢是影响严重OHSS发病率的因素，血脂异常者更易发展为严重OHSS（<0.05），而ET组中严重OHSS的发生率无统计学意义（>0.05）。
本研究结果表明，血脂异常可能会促进OHSS的发生，尤其是对于那些选择全胚冷冻的患者。对于血脂异常且需要全胚冷冻的患者，考虑OHSS风险至关重要。
